Intraocular Candidiasis in Babies with Candida Sepsis

Systemic candidiasis is a life-threatening disease in premature infants and may result in several complications. Early recognition is essential, but it is delayed and treatment is difficult. Candida endophthalmitis develop with systemic infection and intraocular involvement is detected by fundus examination with an indirect ophthalmoscope. Improvement of intraocular lesion and therapeutic effect of systemic candidiasis are detected with careful retinal examination. Twenty five premature infants received indirect ophthalmoscopic examination and we investigated the prevalence of intraocular involvements and related factors for eye involvement. The ocular findings were classified chorioretinitis, endophthalmitis and nonspecific lesion, except premature vitreous haziness. Chorioretinitis in 4 infants and nonspecific lesion in 3 infants were detected but endophthalmitis was not found. There was slight difference in each group for gestational age, birth weight and ventilator etc, but no signifficant statistical difference was noted. Systemic candidiasis was treated with systemic antifungal agent, and the chorioretinitis is resolved with systemic antifungal agents. We propose that retinal examination be performed on all infants suspected of having systemic candidiasis for the diagnosis and early treatment. Funduscopy may be a helpful as an early diagnostic tool, and to monitor appropriate therapy of systemic candidiasis.

A Prospective Study of Intraocular Candidiasis

Intraocular fungal infection, especially due to candida infection, has become an increasingly important cause of nosocomial infectio. Despite increasing awareness of this complication of candidemia, serious visual impairment due to candida infection remains as a problem. For the determine the frequency of intraocular candidasis and evaluation of risk factor, patients with candidemia were evaluated with indirect ophthalmoscopic examination within ninety six hours ater blood culture. Intraocular candidiasis were found in thirty three Percent of patient with candidemia. Candida chorioretiritis were found in five (27%) patients, candida endophthalmitis was found in one (5%) patients. The candida chorioretinitis was not progressed to candida endophthalmitis in one patients. That patient with candida endophthalmitis was treated with intravitreal amphotericin B injection, pars plana vitrectomy. Among the six intraocular candidiasis patients, five patients got cnadidiasis after long term antibiotics therapy for flame burn injury and one after anticancer therapy combined with intravenous hyperalimentation. The risk factors for the development of intraocular candidiasis can be long-term antibiotic therapy, parenteral hyperalimentation, use of indwelling catheter, or use of immunosupressive drugs in our cases.